Utilization Review Specialist - FT

Mental Health Treatment Centers Of America, LLC•Lauderdale Lakes, FL

1d•$65,000 - $75,000•Onsite

About The Position

We are Mental Health Treatment Centers of America (MHTCA), the parent company to mental health treatment facilities serving adults and teenagers with primary mental health disorders. We are in Fort Lauderdale, FL. Come join us as we make a positive difference in the lives of others! We seek an experienced Utilization Review (UR) Specialist to join our team! Schedule: UR Specialist - Monday - Friday 8:30a - 5:00p

Requirements

Time Management skills and working within a fast-paced environment.
Superior written and oral communication skills.
Attention to detail to ensure necessary information is captured and properly documented.
Ability to work independently and within a team.
Ability to multi-task, prioritize and meet expected deadlines.
Solid understanding of insurance benefits and coverages.
Strong computer skills (Word, Excel, billing software).
Understanding of mental and behavioral health treatment services.
Knowledge of Ethics and Professional Standards.
Excellent Interpersonal Skills and Boundaries.
Knowledge of HIPPA, confidentiality and privacy practices.
Knowledge of DCF Guidelines and Joint Commission Standards.
Professionalism, organization, and customer focus.
Ability to manage sensitive and confidential situations with tact, professionalism, and diplomacy.
3-5 years of related experience in the behavioral health field, or an equivalent combination of education and experience.

Responsibilities

Review Client admission and clinical information to ensure medical necessity and compliance of utilization review guidelines.
Obtain initial and continuing authorization for treatment services.
Manage authorization denials including referral for peer review.
Demonstrate the ability to make critical decisions about medical necessity of treatment by using good judgment.
Advocate on behalf of Clients to ensure maximum length of stay at the appropriate level of care.
Interact with insurance companies in a respectful, professional manner that facilitates the utilization review process and follows policies and procedures.
Document and record all necessary information.
Monitor and track new and ongoing authorization cases.
Collaborate and communicate with clinical staff to ensure necessary information is obtained and timely reviews are performed.
Assist the treatment team in understanding payer requirements for admission, continued stay and discharge planning.
Participate in team meetings and case conference reviews.
Maintain confidentiality of Client information and adhere to HIPAA regulations.

Benefits

Comprehensive Health, Dental, and Vision insurance, ensuring you and your family have access to top-notch care
Short-term and Long-term Disability
Voluntary Life and AD&D insurance
HSA and FSA accounts
Worksite benefits - Accident, Hospital Indemnity and Critical Illness plans
Legal plan
Corporate discounts
Employee assistance program
Pet insurance
Enjoy a healthy work-life balance with ample time off so you can recharge and take care of personal matters, which includes: 7 holidays, vacation, sick and personal time-off.
401(k) w/ match with eligibility after completion of 90 days employment to invest in your future and help you build financial security for tomorrow.
We believe in your growth! We have professional development opportunities, that include our ongoing compliance training program, to advance your skills and career.